Ceramir Crown & Bridge: Redefining Cement
For the past 30 years, Lou Graham, DDS, as an internationally recognized lecturer discussing incorporating current clinical advancements, has been focused on providing optimal oral care at his multispecialty practice in the Chicagoland area. “What struck me about Ceramir® Crown & Bridge cement early on was its ease of use,” Graham says. “You can place this cement into a crown, without the need of primers or silanes and then simply seat the crown into place. You have a 2-minute working time and an overall set time at 5 minutes. Cleanup begins at the 3-minute mark. The cleanup is so easy, as the material just peels off and you can’t miss the opaque white color.”
Ceramir Crown & Bridge (C&B) luting cement by Doxa is a dental bioceramic luting cement produced for permanent cementing of conventional prosthetics, including all-ceramic constructions on zirconia, lithium disilicate, and alumina, as well as porcelain-fused-to-metal, making this cement extremely versatile. “For years, I have been using almost all-ceramic materials, but the majority of my work today is zirconia and there are many ways to customize these restorations. I routinely use Ceramir on 95% of my posterior casework (onlays are bonded) along with an ever-increasing usage in my full-coverage anterior restorations. For dentists, there is nothing else like this unique material,” Graham says.
Winner of multiple awards, including the 2010 European Frost & Sullivan Award for Product Innovation, and a recently announced four-time winner of the Pride/Cellerant Best of Class, Ceramir C&B is the first product of a class of unique materials called Nanostructurally Integrating Bioceramics. Ceramir C&B fosters a buildup of nanocrystals that integrate with the tooth (dentin and enamel) and crown material and creates an alkaline environment to resist acid demineralization at the margins and thus minimize the chances of recurrent decay. Unlike other cements on the market, it remains stable chemically in the oral environment and has thermal properties that make it similar to dental tissue, which help minimize stress and microleakage.
Ceramir C&B requires no etching, priming, bonding, or conditioning, saving practitioners valuable time. Patients also benefit from the time-saving component that routine anesthesia for crown cementation is rarely required because there is virtually no sensitivity on placement. “With resin cements, often if you are etching and bonding, you have to anesthetize the patient, which, let’s face it, no one wants. With Ceramir cement, the process for me is cleansing the tooth prior to delivery with a 2% chlorhexidine solution and then simply placing mildly wet gauze over the tooth. After making any required adjustments, the crown is cleansed internally, and then loaded with Ceramir and placed onto the preparation. This is a huge time saver for me, and the patients love the fact that they are virtually sensitive free.”
This easy-to-use product is hydrophilic and handles well in moist environments. Graham adds, “This is a key differentiating point because the majority of my crowns are replacement of previously failing crowns with subgingival margins and this, then, gets into the issues of isolation from gingival crevicular fluid and occasionally saliva.” Resins are contraindicated in such environments and yet, all too often, this is how resin cements are delivered, he says.
“In this crowded cement market,” adds Graham, “everyone in the resin-cement space is trying to obtain easier-to-clean cements. For the dentist, this is the quagmire; you have to get off that resin cement before it sets. But if you remove it too early, this can lead to instant microleakage. For me, resins are required when I need added retention. For the vast majority of my crowns, it’s all about the margin and isolation and that’s why this is my ‘go to’ easy-to-place cement.”
Like most cements, Ceramir also has been shown to become stronger with its physical properties over time. Ceramir C&B also possesses exceptionally good biocompatibility with the surrounding tissues. It’s a calcium aluminate cement and differentiates itself with its bioactivity; early studies by Jeffries show the potential of such cements to actually remineralize a tooth at the marginal interface. As the material comes into contact with the phosphates in saliva, new apatite forms and the potential of creating tooth-like material at the margin is “a game changer,” Graham says.
“Given the unique properties of Ceramir,” Graham says, “these and similar bioactive products on the market are leading the way to significant advancements in our clinical care that we can provide for our patients. For the past 4-plus years, my success with this product has allowed me to maximize my clinical schedule at delivery appointments for full-coverage crowns and equally important for my delivery of my implant restorations when a screw-access approach can’t be accomplished.”
Doxa Dental Inc.
150 N Michigan Ave
Chicago, IL 60601